Written by Greg Arnold, DC, CSCS. Oral nutritional supplementation for hospital patients reduces hospital costs by 12%, risk of death by 35%, complications by 35% and length of stay by 13%.
Malnutrition is defined as “when your body does not get enough nutrients” (1) and is estimated to cost $3.5 trillion worldwide (2). While malnutrition is thought to mostly affect young children in underdeveloped countries, it is a significant problem in the elderly and has been regarded as “an unrecognized health issue” (3). About 60% of hospitalized adults 65 or older and 35-85% of adults in long-term care facilities suffer from malnutrition (4), with 72 million elderly people in the United States expected to suffer from malnutrition by 2030 (5).
Now a new research review (6) suggests that nutritional supplements may be an effective way to address malnutrition in the elderly. In the study, researchers reviewed 14 cost-analysis studies of outcomes in patients admitted to hospitals. The studies included overall cost of their stay, total days in the hospital and whether they received oral nutritional supplementation or not. The researchers defined oral nutritional supplementation as “a commercially available, ready to consume, multi-nutrient (complete or incomplete), liquid or semi-solid product providing a mix of macronutrients and micronutrients produced by specialist medical nutrition manufacturers.”
The researchers found oral nutritional supplementation to be superior to no supplementation in 12 of the 14 cost analyses, providing an overall cost savings of 12.2% (p = 0.027), reducing the risk of death during the hospital stay by 35% (p < 0.05), reducing complications after admission to the hospital by 35% (p < 0.001), and reduced length of hospital stay by 13% (∼2 days, p < 0.05).
The researchers did admit that because some of the studies included dietary advice, additional vitamin D and calcium supplementation, “it is not always possible to ascribe all the benefits to oral nutrition supplementation.” Nevertheless, they concluded that “standard oral nutrition supplementation in the hospital setting produce a cost saving and are cost effective” and that “to undertake more high quality studies to further define the patient groups likely to benefit from appropriate amount and duration of ONS administration in different care settings.”
Source: Delmi, M., et al. “Dietary supplementation in elderly patients with fractured neck of the femur.” The Lancet 335.8696 (1990): 1013-1016.
© 2017 Elsevier B.V. or its licensors or contributors
Posted August 13, 2015.
Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY. You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com.
References:
- “Malnutrition” posted on MedLine Plus
- “Understanding the true cost of malnutrition” posted on Food and Agriculture Organization of the United Nations website
- Maher D. Malnutrition in the Elderly: An Unrecognized Health Issue. Published on the Journal of Nursing website
- Furman, E.F. (2006). Undernutrition in Older Adults Across the Continuum of Care.
- National Institutes of Health. (2006). Dramatic Changes in U.S. Aging Highlighted in New Census, NIH Report.
- Elia M, et al., A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in community and care home settings. Clin Nutr 2015 May 29. pii: S0261-5614(15)00142-9. doi: 10.1016/j.clnu.2015.05.010. [Epub ahead of print]
